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<jsp:include page="header.jsp" /><script src="js/jquery.validate.js" type="text/javascript"></script>

<script type="text/javascript">
$(document).ready(function() {
	$("#frmRegistro").validate();
});
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</head>
<body>
<div id="contenedor">
<div id="header">
	<div id="header-left">
    	<jsp:include page="logo.jsp" />
        <jsp:include page="login.jsp" flush="true" />
    </div>
    <jsp:include page="banner.jsp" />
 </div>

  <div id="registro">
  	<h1>Registrate Aqu&iacute;</h1>
    <form name="frmRegistro" id="frmRegistro" action="" method="post">
    	<div class="columns">
        	<div class="col-0">
  				<div class="fieldContent">
                	<div class="etiqueta"><label for="txtEmail">Email</label></div>
                    <div class="field"><input type="text" name="txtEmail" id="txtEmail" size="40" class="required" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta">
                	  <label for="txtContrasena">Contrase&ntilde;a</label></div>
                    <div class="field"><input type="password" name="txtContrasena" id="txtContrasena" size="40" class="required" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta"><label for="txtRContrasena">Repetir Contrase&ntilde;a</label></div>
                    <div class="field"><input type="password" name="txtRContrasena" id="txtRContrasena" size="40" class="required" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta"><label>Cliente Premium</label></div>
                    <div class="field">Si <input type="radio" name="rbPremium" id="rbPremium" value="Si" /> No <input type="radio" name="rbPremium" id="rbPremium" value="No" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta"><label for="txtNumeroTarjeta">N&ordm; Tarjeta</label></div>
                    <div class="field"><input type="text" name="txtNumeroTarjeta" id="txtNumeroTarjeta" size="40" class="" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta"><label for="txtNombres">Nombres</label></div>
                    <div class="field"><input type="text" name="txtNombres" id="txtNombres" size="40" class="required" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta"><label for="txtPaterno">Apellido Paterno</label></div>
                    <div class="field"><input type="text" name="txtPaterno" id="txtPaterno" size="40" class="required" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta"><label for="txtMaterno">Apellido Materno</label></div>
                    <div class="field"><input type="text" name="txtMaterno" id="txtMaterno" size="40" class="required" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta"><label>Sexo</label></div>
                    <div class="field">M <input type="radio" name="rbSexo" id="rbSexo" value="M" /> F <input type="radio" name="rbSexo" id="rbSexo" value="F" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta"><label for="txtDireccion">Direcci&oacute;n</label></div>
                    <div class="field"><input type="text" name="txtDireccion" id="txtDireccion" size="40" class="required" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta"><label for="txtDistrito">Distrito</label></div>
                    <div class="field"><input type="text" name="txtDistrito" id="txtDistrito" size="40" class="required" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta"><label for="txtCiudad">Ciudad</label></div>
                    <div class="field"><input type="text" name="txtCiudad" id="txtCiudad" size="40" class="required" /></div>
                </div>
  				<div class="fieldContent">
                	<div class="etiqueta"><label for="txtDepartamento">Departamento</label></div>
                    <div class="field"><input type="text" name="txtDepartamento" id="txtDepartamento" size="40" class="required" /></div>
                </div>
            </div>
            <div class="col-1">
            	<div class="fieldContent">
                	<div class="etiqueta"><label for="txtDNI">DNI</label></div>
                    <div class="field"><input type="text" name="txtDNI" id="txtDNI" size="40" class="required" /></div>
                </div>
            	<div class="fieldContent">
                	<div class="etiqueta"><label>Fecha de Nacimiento</label></div>
                    <div class="field">
                        <select name="cmbDia">
                        	<option value="">D&iacute;a</option>
                        </select>
                        <select name="cmbMes">
                        	<option value="">Mes</option>
                        </select>
                        <select name="cmbAnio">
                        	<option value="">A&ntilde;o</option>
                        </select>
                    </div>
                </div>
            	<div class="fieldContent">
                	<div class="etiqueta"><label for="txtTelefono">Telefono</label></div>
                    <div class="field"><input type="text" name="txtTelefono" id="txtTelefono" size="40" class="required" /></div>
                </div>
            	<div class="fieldContent">
                	<div class="etiqueta"><label for="txtCelular">Celular</label></div>
                    <div class="field"><input type="text" name="txtCelular" id="txtCelular" size="40" class="required" /></div>
                </div>
            	<div class="fieldContent">
                	<div class="etiqueta"><label for="cmbOcupacion">Ocupaci&oacute;n</label></div>
                    <div class="field">
                        <select name="cmbOcupacion">
                        	<option value="">Seleccionar</option>
                        </select>
                    </div>
                </div>
                <div class="fieldContent">
                	<div class="etiqueta"><label for="cmbECivil">Estado Civil</label></div>
                    <div class="field">
                        <select name="cmbECivil">
                        	<option value="">Seleccionar</option>
                        </select>
                    </div>
                </div>
            	<div class="fieldContent">
                	<div class="etiqueta"><label for="cmbFavorito">Cine Favorito</label></div>
                    <div class="field">
                        <select name="cmbFavorito">
                        	<option value="">Seleccionar</option>
                        </select>
                    </div>
                </div>
            	<div class="fieldContent">
                	<div class="etiqueta">
                	  <label></label></div>
                    <div class="field"><input type="submit" name="btnEnviar" value="Registrarme" /></div>
                </div>
            </div>
        </div>
    </form>
  </div>
  
  <div class="clear"></div>
  <jsp:include page="footer.jsp" />
</div>

</body>
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